HomeMy WebLinkAbout939 Caroline St (11)ELECTRICAL PERMIT
CITY OF PORT ANGELES
360-417 -4'735
PUBLIC BUILDINGS & PARKS
0
REPORT STATE SATES IAX
on your excise tax form
to the City of Pori Angeles
(Location Code 0502)
NJN\'lDSApplication Nudcer
ApplicaEion pin number
Propertsy Address
ASSESSOR PARCEIJ NUI4BER :
Applicat j.on tlpe description
subdivision Name
ProperLy Use
Property zoning
Application vafuaEion
18 oooo1238 Date 8/a'7/1-B
521394
9:9 CAROLINE ST
06 30 00 1 0 3325 0000-
ELECTRICAL ONLY
Application desc
Access upgrade
PUBLIC EOSP]TAL D]STRICT #2
939 CAROI]INE ST
PORT ANGE],ES WA 983 62
l35O ) 4L',7-7\',70
EPIC ELECTRIC INC
PO BOX 35?
SNOHOMISH
(350) s68 5 985
wA 982 91
PermiL
Additional desc
PermiL Eee
I saue Date
Expiration Datse
96.00
I / o'/ /782/03/te
E],ECTRlCAI, ALTER COMMERCIAL
Plan Check Eee
Valuation
00
0
oEy Unit Change Per
1.00 95.0000 ECH EL TRIP FEE-INSPECT EX, INSTAL
ExLensio11
95. 00
Charged Pai d Credited Due
Permit Fee Total
Plan Check Total
Grand ToEal
95.00
.00
96.00
96. 00
.00
96.00
00
00
00
00
00
00
PERMIT WILL EXPIRE SIx (6) MONTHS FROM LAST INSPECIION
INSPECTION TYPE DATE:RESULTS:INSPECTOR:
DITCH
SERVICE
ROUGH-IN 6/p ltt ea TP
FINAL sln ln #T}
COMMENTS:
Signature ofowner or Electrical Contractor X Date:
ELcoM IMULTI-FAMI LY / COMMERCIAL
ELECTRICAL PERM IT APPLICATION
Public Works and Utilities Department
321 E. 5th Street, Port Angeles, WA 98362
360.417.4735 www-cityofpa.us electricalpermits@cityofpa.us
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&Project Address
Project Description
Otv
c
! Nilulti-Family Residential n Commercial / lndustrial / Public Building Square footage
O\i\NER INFORMATION
Name
tvlailing Address
Email
Phone
Mailing Address
Email L
'?D.l Expiratio n Date: ,f: - b '\ 9,
Phone
PROJECT DETAILS
Item
Service/Feeder 200 Amp.
Service/Feeder 201400 Amp.
Service/Feeder 401S00 Amp.
Service/Feeder 601 -1 000 Amp.
Service/Feeder over 1000 Amp.
Branch Circuit W Service Feeder
Branch Circuit WO Service Feeder
Each Additional Branch Circuit
Branch Circuits 1-4
Temp. Service/Feeder 200 Amp.
Temp. SeNice/Feeder 201-400 Amp.
Temp. Service/Feeder 401$00 Amp.
Temp. Service/Feeder 601 -1 000 Amp.
Portalto Portal Hourly
Sign / Outline Lighting
Signal CircuiuLimited Energy - Multi-Family
Signal CircuivLimited Energy/First 1500 sf - Commercial
(Noter $5.00 for each additional 1500 sf)
Renewable Elec. Energy: SKVA System or less
Thermostat (Note: $5 for each additional)
Quantitv fgh! (Quantity x Unit Charge)unit Cha.oe
$132.00
$160.00
$225.00
$288.00
$410.00
$5.00
$74.00
$s 00
$86 00
$102.00
$121 00
$164.00
$185.00
$96.00
$88.00
$88.00
$96.00
I
$
$
$
$
$
$
s
$
$
$
$
$
$
$
$
$
$
t
Qc,'\
$'1'13.00
$56.00
oC..>
TOTAL
Owner as defined by RCW 19.28.261. ('l) Owner will occupy the struclure for two years afte. thas electrical permit is finalized. (2) Owner is
required to hire an eleqlrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection
After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor I
am making the electrical installation or alteration in compliance with the electrical laws, N. E.C., RCW Chapter '19.28, WAC. Chapter 296-
46B, The City of PortAngeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electracal Permit Applications.
g-1-l {-'
Date Print Name Signature (E Owner S Electrical Contractor / Administrator)
[Electrical Permit Applications may be submitted to City Hall or epermits@cityofpa.us or faxed to 360.417 .47'11)
ELECTRICAL CONTRACTOR INFORMATION
Name:
2G.'.,Jq9
t
KS-